1538423892 NPI number — MR. YAN RAYKIS MS ED/SPECIAL ED

Table of content: MR. YAN RAYKIS MS ED/SPECIAL ED (NPI 1538423892)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538423892 NPI number — MR. YAN RAYKIS MS ED/SPECIAL ED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAYKIS
Provider First Name:
YAN
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS ED/SPECIAL ED
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538423892
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O.BOX 957
Provider Second Line Business Mailing Address:
( 103 LIVINGSTON LANE )
Provider Business Mailing Address City Name:
GOULDSBORO
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-703-4643
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2439 E 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11223-6043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-703-4643
Provider Business Practice Location Address Fax Number:
347-492-4888
Provider Enumeration Date:
07/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com